Working with Men in Clinics and Communities: Experiences from Four Countries

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Working with Men in Clinics and Communities
Experiences from Four Countries
Ashoke Shrestha, Lissette C. Bernal, Moustapha
Diallo, Andrew Levack, Manisha Mehta, Dirgha Raj
and Maria Lorencikova September 2003
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Why Work with Men in Clinics

• Training to service providers to work with male
  clients has been nonexistent
• Until now providers have seen reproductive health
  primarily as a womans issue and therefore, RH
  training has focused on Ob/Gyn
• Need for clinical training to address mens RH
  needs

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EngenderHealth

• MAP uses evidence-based approaches to increase
  mens involvement in RH.
• Increasing mens support of their partners RH
  choices
• Increasing mens awareness and behavior to
  safeguard the health of their partners and
  themselves, especially through the prevention of
  STIs
• Increasing, for those interested, the use of
  contraceptive methods that involve direct
  participation by men

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A Tool to Work with Men and For Men

• The Mens RH Curriculum is designed to provide
  health care workers with the skills and
  sensitivity needed to work with male clients and
  provide mens RH services.
• It can be used in a facility that is either
  initiating or expanding a male RH services
  program

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The Mens RH Curriculum

• Section 1 Introduction to Mens RH Services
• Section 2 Communicating and Counseling with Male
  Clients
• Section 3 Clinical Management of Mens RH
  Problems

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Countries to be Highlighted

• Bolivia
• La Paz, El Alto, Cochabamba
• Guinea
• Kaloum Commune, Conakry
• Nepal
• Nawalparasi District
• Pakistan
• Punjab province

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Key Research Findings

• Interested in and desire information and
  discussion of RH issues
• Participate in household and family life
• Understand the challenges, provided the tools to
  address the HOW

Source El Momento de Involucrar a los Hombres
en la Salud Sexual y Reproductiva CISTAC and
EngenderHealth, 2001.
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Build Capacity at the Clinic-level

• Train Service Providers in Male Services using RH
  curriculum
• Provide Manual and Job Aids
• Make the Clinic Male-Friendly

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Create Awareness and Demand for Male Services

• Training peer educators and community members in
  communication skills
• Organizing Street Dramas
• Distributing promotional materials
• Innovating Referral Linkages
• Mass Media Campaigns

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Create Awareness and Demand for Male Services
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Evaluation Plan

• Pre and Post KAP surveys during training
• Action Plan Development
• Continuous Monitoring
• Interviews/FGD with Service Providers, Clients
  and Peer Educators
• FGD with Community Leaders

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Results

• Increased knowledge and positive attitudes among
  service providers and community members toward
  male involvement in RH
• Increased access by men and their partners to
  RH/FP services in the communities where male
  involvement activities have been implemented
• Increased range of services offered at facilities

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Results Provider KAPs

• Question A service provider or counselor can
  effectively provide services to a male client
  even if his or her values differ from the
  clients.
• Pre-Test 44 agree
• Post-Test 100 agree

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Results Provider KAPs

• Question Ways to make men feel more
  comfortable at a health care facility include
• a.       Placing reading materials geared
  toward men in the waiting room
• b.      Designating a male rest room within
  the facility
• c.       Using a name for the facility/program
  that welcomes both men and women
• d.      All of the above
• Pre Test 22 Correct
• Post Test 89 Correct
•  

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Results Client Usage
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Results Client Usage
Use of Services by Sex
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Results Range of Services
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Lessons Learned

• Strategic Alliances are Critical
• Stakeholders must be involved to ensure the
  projects success
• Public and Private entities (I.e., MOH, NGOs,
  etc.)
• Peer Educators youth and adults
• Clinic Staff
• Religious Leaders and Community Members

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Lessons Learned

• Consider both Supply and Demand
• Integrate with Existing RH Services
• Buy-in and support from managers is critical for
  success
• Effective outreach to men includes special
  communication and marketing strategiesGo to
  where the men are!